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General NPI Number Information
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NPI Number | 1083087928
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Entity Type | Organization
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Legal Business Name | SANTA CLARITA DIALYSIS, LLC
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Dates
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Enumeration Date | 10/31/2015
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Last Update Date | 10/31/2015
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Provider Practice Location Address
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Address Line | 23421 LYONS AVE
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City | SANTA CLARITA
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State | CA
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Zip | 91355-3028
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Country | US
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Telephone | 818-365-1194
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Fax |
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Provider Business Mailing Address
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Address Line | 11550 INDIAN HILLS RD SUITE 371
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City | MISSION HILLS
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State | CA
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Zip | 91345-1200
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | MANAGING PARTNER
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Name | OMARAN ABDEEN
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Credential | MD
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Telephone | 818-365-1194
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QE0700X
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Taxonomy Name | End-Stage Renal Disease (ESRD) Treatment Clinic/Center
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License Number |
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License Number State |
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